Rapid response team helps seniors in need

"Mrs. L" is a 91-year-old woman who lived in Nazi-occupied Poland before escaping to England and then to the United States. She now lives in Ventura County with her adult son and shows signs of dementia.

"Mrs. L frequently states there is a man in her attic stealing her food, that he lives in the neighborhood and takes neighborhood children away," said Marcy Snider, a Ventura County Adult Protective Services case worker.

Snider presented the case study before an audience of about 50 who gathered Wednesday at the Ventura County Public Health Department in Oxnard to hear a report on the Rapid Response Expert Team.

The team is a pilot program formed in July to help vulnerable seniors and dependent adults get the help they need. The team of experts was put together by Adult Protective Services staff using a $654,000 grant from the U.S. Administration on Aging.

Linda Henderson, deputy director of the county's Adult and Family Services Department, said the grant was the largest in county history for a program preventing elder mistreatment.

The agency already had a team of social workers, and the grant money was used to add a physician, nurse, mental health clinician and neuropsychologist.

Henderson said the results have been excellent. Using a Power Point presentation Wednesday, Henderson showed how the right mix of experts for each specific situation resulted in a satisfying resolution.

In the case of "Mrs. L," the adult son living with her failed to see a problem with his mother, although she was calling 911 as many as four times a day and had to be put on a 72-hour psychiatric hold.

"The son denied any problems existed," Snider said.

The team can send certain experts to a senior's home, Henderson said.

"Calling people up is not as successful as knocking on the door," said Grace Deisler, a social worker with Adult Protective Services and a team member.

Frail elders frequently have transportation problems and can't get to the resources they need or may have undiagnosed cognitive problems that keep them from getting help, Henderson said.

Geriatric physician Dr. Esther Yoon might be called if the senior is experiencing medical problems. Yoon literally makes a house call.

"They allow you to examine them and talk to them in their homes," she said. "Usually I take two to three hours per patient. ... I try to get them to sign a consent form so I can send it to their physician."

Yoon was on the team that responded to Mrs. L, who had suffered from colon cancer as well.

Henderson also detailed the new system Adult Protective Services developed to help assess the needs of each of the 87 cases that have been handled by the team between July 2010 and April 2011. The standardized tool contains 56 biological, social and psychological indicators as well as early signs that could point to an elder in need of assistance.

"This goes one step further in making sure the problem with the elder is improved," she said.

Henderson said her agency hoped to see improvement in 70 percent of the cases. The results were even better —improvement in 89 percent.

In Mrs. L's case, Yoon and a neuropsychologist on the team got her the right medication and psychiatric attention. A social worker worked with the son to get him to understand his mother's cognitive problems.

Now, Mrs. L is living independently in her home with her son, and the calls to 911 have stopped.

The team's funding runs out June 30, so Henderson and Adult Protective Services staff are trying to get a new grant or other funding. She believes she can keep it going with $200,000.

One suggestion came from audience member Dr. Lanyard Dial, executive director of the Livingston Memorial Visiting Nurse & Hospice Association. "I think the county could hire a full-time geriatric physician to do this and it would save the county a lot of money," Dial said.

Dial said Yoon or someone with her specific qualifications would be ideal.

Henderson said she liked the idea and planned to follow up with Ventura County Health Agency Director Dr. Bob Gonzalez and the county's top executive, Mike Powers.